the mission - prelude

For the past few years I had been involving in medical mission organized by churches on a yearly basis. A promise which I intended to keep after my PCI few years ago; I however leave it to the great one to decide where my destination. The missioner serving in India had returned at the beginning of this year and I knew that a returning to India is impossible this year. I was contacted by the local assistant pastor in charging of the foreign mission earlier this year; she had told me that 3 missions would be held this year and one of the options was China which I instant stroke out from the list. Application of a visa to China is a pain of the aXX for me as I need to hand my passport to an agent and sent it to HK for application. The next option was Satun and Bangladesh. I opted for Bangladesh as I had never been to that part of the world. 5 years ago during my 1^st mission, I had chosen Bangladesh as my first choice but was redirected to Satun for some reason.

After the inquiry, everything went silent and I was a little happy that maybe the great one had wanted to move the jubilee forward a few year for me(yeah, yeah, I knew it was only year 5….). Well, after I finalized our trip to Kansai. I got contacted by one of my mission mate asking me if I wanted to do any trip this year. I told her that I had opted for Bangladesh early this year but no one had contacted me. She told me that much had happened and the asst pastor who in charge of the mission was reassigned and another new asst pastor had taken over the job. However due to various reasons, pass-over was not done properly the new kid on the bloc did not aware that I existence. The Bangladesh team was still short of physician. My ex-team mate Z (a nursing practitioner) had opted to go to Satun with a catechumen(chief resident in family medicine) and we had exchanged idea about trip for catechumen;  we both agreed that Satun is a more civilized place to go for a catechumen. Z had asked me if she could mentioned my name again to the new asst pastor in charge as the Bangladesh team is still short of medical staff and I complied.

Days later, I had gotten a call from the new asst pastor in charge C and I had accepted his invitation; I knew that there is no place for me to hide.

The Satun mission was later cancelled and Z and her friend C had joined the Bangladesh team.

always 50/50......

The 70+ y/o pt was sent over by a ambulance. He was having his breakfast and later felt dizziness and he had just laid his head over the table. The restaurant owner had help him onto his car and sent him to the local rescue ambulance. He had reached our ED 30min after the incident. He was alert and initial neurology examination had revealed left eye hemianopia but muscle power was well over both limbs. I had did a quick NIHSS evaluation and found out it was 9; just slight above the requirement for tPA therapy. The brain CT was normal and diagnosis of rt PCA infarction was made. The patient is a loner and no spouse nor child was available. His nephew was on his way and it would be more than enough time to start the tPA in 4.5hr window. However I was in a stranded condition due to delay of CT(CT was done slightly more than 25min) due to chest discomfort of patient(EKG was ordered…). If this case had made it to tPA therapy list, it would made our treatment result index ugly.(we do only a handful of cases per year and any case which failed to achieve the therapy standard would down pulled the total data of the TCPI). Well, CT did not show any hemorrhage and he was definitely a candidate. The condition had worsen as his relative would be arriving late causing another violation(tPA should be given within 1 hrs of arrival in ED).

Double violations and after I obtained all the lab data and completed the check-list, I had gone to talk to the patient for a final time explaining the risk and benefit of the therapy. He had however expressed that he would not want to take the risk of intra-craninal hemorrhage and refused the suggestion of tPA therapy. A relief for me and I had reassured him that with proper therapy and rehabilitation he would recover fine. I informed the neurologist about the situation and he was admitted to ICU.

Few days later, I met the neurologist and he told me that despite of the MRI done on next day that revealed a large area of involvement of rt PCA region, his condition had however improved.

The tPa infusion sometimes worked like a miracle and sometimes…My colleague had a bad experience where the patient did not suffered from hemorrhage but still deteriorated few days later, the case had nearly ended up in a lawsuit. I always tell my patient, the possibility of an incidence to occurred means nothing to the patient, the odds of happening is always 50/50 for any incidence to occurred; it is either yes or no. Those statistic data is only useful reference for the doctor; you never know you are the 99 or the 1….

Well, sometimes, do nothing is better than do something....

Kansai - the return

The returning journey was one of the most worrying part; initially it was typhoon Cimaron, then it was the train catching part. We would need to take the Sakurajima line from USJ to the Nishi Kujo eki and hop onto the Kansai-Airport Express train which run 2 shifts per hour. It seems simple but yet a missed might ended up with a rush situation. We woke up early and reach Nishi Kujo station in time to catch the Kansai-Airport Express. It was not a working day but the train was crowded and no seat was noted on our boarding. We were however able to secure a seat for everyone half way of the journey.

We proceeded to the airport food court and did a final food round prior to our departure. The fried noodle, curry rice and tempura were up to the standard. We proceeded to T2 after the overloaded breakfast. The kiosk check-in was unsuccessful like our last visit; the booking name and passport name was not consistent. Our name had 2 spaces separated and the booking name was noted only with 1 space. Well, it was smooth and we passed the immigration without any difficulty. The rest of the journey was uneventful…..

It was a satisfying journey for everyone.

One month later, Kansai was hit by typhoon Nabi and quite a few places we visited were wrecked.

My asthma had become worst on the day of departure and I had to return to my desk with a tight schedule while another hectic tour was waiting for me around the corner 1 week later.

Kansai...USJ

We had gone down early to the convenient store and grabbed some breakfast before we left the hotel. Out of our expectation the USJ was not packed with crowd at the entrance. We had a smooth passage and proceeded to the rides. The rides were really special and I had no regret buying the fast pass. At noon, we had our lunch at the Three Broomstick restaurant. Though the food was so so but it was a great experience having lunch in the restaurant. We bought some wands and tried out the butterbeer and pumpkin juice. A short period of raining was noted but did not disrupt our trip.

By 5pm we had finished our final ride – the Forbidden Journey at the Harry Porter World. I had never been to any similar ride like it in the past; stunning experience for everyone of us. We left the USJ by 8:30pm and waited a long queue for a seat at the rotational sushi along the walk.

The weather had helped a lot; visitors were less than expected and we enjoyed a great day in the park. After all those day of worrying, everything had proceeded accordingly. It was a tiring day for us but the challenging part was to catch our train early next morning.  

Kansai- pre-USJ

We had leaved the apartment late and took a slow walk with our baggage to Kyoto station for our ride to Osaka. It was a 1+ hr train journey and I fallen asleep during the ride as I had been disturbed by cough since our arrival. The room was filled with dust and my asthma had recurred since our arrival.

The Shin Osaka station is huge and its underground passages are just like a maze with no end. We had located some locker and stored our baggage and did a quick tour around the station surrounding. We ended up eating Okonomiyaki at one of the shopping mall. We proceeded to the USJ at around 3pm. The train station was filled with people as the local govt had announced that the train service will end early in the evening due to the typhoon. The USJ had also closed prematurely at 5pm due to the typhoon. We were lucky enough to get a seat in one of the restaurant located in the city walk mall near our hotel.

We took a walk around the pier of the Osaka bay after our dinner. From time to time, gust of wind had cruised down the walking lane; we could sensed that it would be a big one. However nothing was more striking than big crowd of customers storming the convenient store nearby the hotel for food as most of the restaurant nearby was closed and the rail service had shut down due to the typhoon.

I crossed my finger praying that the USJ would open as usual and no rain would be there to disturbed our journey.

That night was an uneasy one as the gust of wind constant shattered the building and making uncomfortable noise. Rain was also noted. I was disturbed by my wheezing and woke up early At 5am,  looking through the window, I noticed that the sky was slightly filled with dark cloud and the wind had stopped….Well, I knew that our last leg of trip would be finally materialized. 

Kansai- Kyoto

I had made adjustment of our original plan as the railway museum was closed on Wednesday. We were forced to switch our plan and headed to Kiyomizu-dera and railway museum on D1. We had heated our breakfast and left the apartment early. We took a small hike and reached the temple by 10:30am. It was a tiresome hike and we had tried out some macha food and drink on the way down. It was a tiresome hike as the weather was hot during our climb. We headed back to Kyoto station and have our lunch at Toyoutei hoten. Outlet of one of the oldest western food joint in Kansai area which had opened since 1897; Toyoutei was famous for its curry and hamburger steak. Both are my favorite and we had a good meal before we headed to the railway museum.  

The railway museum was fascinating; there were so many engines being exhibited. There was this simulator room but we had to give it a pass as everything was in Japanese. It was not a usual tourist spot for foreigner, most of the visitor there was locals….

We headed back to the Kyoto station and had a tour around the shopping lot. We had a late dinner at one of the rotational sushi outlet around the station. The day ended after scouting around at the BIG CAMERA shop nearby. Xian was disappointed as we did find a load of Amiibo in the shop like we did last year.

As usual we picked up a load of foods from the local convenient store for breakfast tomorrow. We bought rice, sweat sour pork, fried noodle and much more…Canned coffee was one of my favorite and Xian was keen to try them out on this trip; I ended up buying quite a few on our way back.

We pushed out early as usual after our microwaved breakfast in the apartment. I had picked railway as our mean of transport and It was a wrong move; long walk from the train station to the entrance of the Nijo Castle. It was a must see for me as we had missed the Osaka castle during our last trip. It was like walking into a movie scene during our walk in the castle.
We had some snack at the canteen and later proceeded back to Kyoto station for some takeaway food at the supermarket before we headed to Kyoto museum.

Kyoto museum was a boring one but we were able see lots of common staff that was originated from china. Our dinner was pre-booked months before our trip. I had ever wanted to eat some good Japanese beef during our trip and I found this Yakiniku shop around Kyoto station. They had a website and I was able to pre-booked it online.

The Wagyu was off limit to Taiwan for a long time due to mad cow disease. Later its import permit was reinstated and 1/5 of Wagyu export was exported to Taiwan. An expansive dinner but the taste was beyond described.

We retreated back to our apartment early and prepared our trip back to Osaka for the USJ trip.

Typhoon Cimaron had speeded up since our arrival and I was pretty sure that it would pass Kansai the night before our USJ trip and I was confident that our return flight would not be cancelled. However the most worrying part was not the wind but the rain. Raining after typhoon was the most irritating part as it might be more destructive than the typhoon itself. We might still have the chance of being stranded in the hotel because of the rain.

The 2 days Kyoto tour was a smooth one, we had used train, bus and our legs to wander around. We had been to special place and broaden our view. The next part of our journey was filled with uncertainty initially and I thank the great one of letting us to travel so far.

Kansai....D1

I spent much time on the Google and finally drawn out a rough plan for our trip.

The departure was complicated. Ving and Yun and Xian had struggled to pack the luggage into cabin baggage standard so that we would have a smooth passage during the entry. Well, I thought it was unnecessary as we would be delayed during the immigration check. The packing had delayed our schedule; we leave our house 40min late than expected. We were still able to reach the airport in time and took a quick bite at the airport restaurant. I was worn off and fallen asleep before the flight took off as I had done night shift the night before the trip; it was a rough shift and I had slept less than 3 hours.

We touched down as scheduled and it took us 40mins to get pass the immigration. Yun and I had gone to buy train ticket to Kyoto while Xian and Ving had bought some Horai Bao and dumpling as snack. We reached the train platform 20mins prior to the departure and was lucky to board the train and gotten a seat for everyone. The train ticket was 1/3 of the local price and only available to foreigner, however it was on free seat basis, so on a pack day, passenger might need to stand all the way to Kyoto.

We arrived at Kyoto around 9pm and was unable to grab anything from the food court at the basement of the Kyoto station. We had gone for our backup plan by eating at a Ramen shop nearby the station. The food was nice and cheap. Ramen and fried chicken; simple foods that were good enough to keep a few hungry soul to move on.

It was a short walk of 1 km from the station. On the way, we grabbed some food and water from the nearby convenient shop; we had decided to have our breakfast in the apartment as we are not that keen of the Japanese type breakfast - soup and rice.

The apartment was great as commented by other travelers. I revised our plan before we gone to sleep as the train museum we would supposed to visit on D2 was closed. Everything was still under control but there was one factor that bothered me since 1 week before the journey – Typhoon Cimaron….

The typhoon was formed 1 week before our journey and I had been tracking its course since it was formed. One of the most worrying part was the day it would hit Kansai. The initially speed was slow and it would be a narrow escape for us if it continue with the same speed. I was haunted by the prediction but did not reveal it the rest of the family. On the day we arrived in Kansai, I was pretty sure that that Cimaron will miss Kansai airport on the day of our return, but we might be facing the typhoon during our visit to USJ; bad situation but better than finding for another return flight as PEACH airway is a low cost carrier and does not offer any service to find seat should the flight is cancelled. However the USJ ticket was non-refundable and I had spent a good load buying a fast pass-7 for everyone, all I could do was prayed....

Kansai revisited, pretrip

It was a planned trip, I defined it as a celebration trip for Xian graduation. During Xian childhood, it was a dream seeing him going to school as a normal child. However we did it, Xian had graduated from junior high. It was an amazing journey seeing him growing up. Well, he made it.

The last trip to Osaka was a short and a surprised one and we did not visit the Universal Studio Japan. Xian had been a fan of Resident Evil and he had tried most of the version/generation during the last few years. He was actually attracted by the live show of Resident Evil organized by USJ for the past few years. We were looking forward to its rerun this year during summer holiday unfortunately it didn’t. However, we had still proceeded with our plan. I had decided to visit Kyoto and later ending the trip in the USJ during the trip. It was a 6d5n trip (vs the 4d3n few years back)…The planning was a complicated one.

The choice of lodging had disturbed me for a few weeks as I need to find a spot near traffic facility during our stay in Kyoto. Our last stay in an apartment around nipponbashi was an excellent experience. I had sought out to seek similar apartment style lodging but most of it was at a distance from the Kyoto bus station. After week of seeking, I finally got a apartment which was 1.2km from the Kyoto station. A short walk with would passed by 2 convenient shop along the way; it was a must so that we could collect some food/supplement along the way back. The great thing about apartment was the facility to cook and prepare breakfast/supper. Unlike Malaysian and Taiwanese, the Japanese seldom have the breakfast in a food shop; you can only found western type breakfast shop. The Japanese would have simple breakfast such as rice ball or rice with soup.

The choice of staying in Osaka for the USJ trip was more challenging. There was no apartment located around the USJ. The only choice was hotel and all of them cost a hand and a leg for any room for 4. I had chosen the cheapest one to facilitate the visit. However   the most stunning part about the visit was the ticket [plus the fast pass of course]. Nothing to shout as it was full peak season during the summer holiday.

It was a walk till you drop trip as we planned to use bus and train as our choice of transport. Detail of dinning in which food shop was one of the challenging part. So many detail to work on and I could only relay on google……

Everything was seemed to be set 2+ months before the journey, however another challenge was waiting for me after the trip and I took the bite….

foreigner with no relative....

It was a boring Sunday shift…everything was slow until I got a call from a hospital down south. It was a referral; the local ED down south wanted to refer a case of intracranial hemorrhage. A usual referral with an unusual patient…The patient was a foreigner. That means there would be a pain in the axx should he required any invasive procedure that require consent…. I did not hesitate to accept the referral as we are the nearest hospital with neurosurgeon oncall. I did however asked them to faxed over his passport page so that I could called up the relevant department for help.

5 minutes later I got the fax and noted that he was Canadian. His birth place was however Ipoh…

The patient arrived 1 hr later; he was intubated and the imaging revealed subarachnoid hemorrhage which suggest aneurysm rupture. Appropriate management was rendered and nothing more that I could do except to ask for a neurosurgical consult.

I called up the Canadian representative office up north and the call was redirected to foreign ministry office in Canada. I provided the officer on call with the relevant information and asked them to help me to contact his family so that further management plan could be discussed.

The owner of the R&B lodge had accompanied him to our ED. He was also a Caucasian who run the lodge with his girl friend(Taiwanese of coz). The patient was a lone traveler who had visited mainland for over two weeks before he landed and joined a PADI diver course down south. He had ridden an electric bike roving around the town after breakfast and later found lying along the roadside unconscious….

We had glanced through his belongings and found an I-phone. A good news and most probably we could get contact number from it. However we had failed to assess the phone as he did not set up finger print lock….So that was why I sought help from the Canadian representative office.

While waiting for consult I had decided to call the immigration office as the patient would need to filled up an entry card during his entry and it might contain useful contact no. I called up the head office and the on call officer had referred me to the Taipei Airport immigration. I got a returned call later and the officer had told me that they would refer the matter to their colleague in Vancouver for further help.

The next 3 hours was a busy one and I had successfully got a referral  to a medical center in K city. 
Prior to the referral, I got a call from the on duty officer of immigration agency. The officer told me that their agent in Vancouver had successfully contacted the local police and found the relative. The relative had gotten my contact number and would call me soon. 
I got the call minutes later and informed the family about grave condition. They told me that there would be a closed friend staying in K city that would managed the whole event for them. I called up the given number and told the friend about the condition and suggest him to act accordingly.
The patient was transferred out later...
I had however run a check over the net and found that Malaysia did not provide any similiar service for its national during such emergency-> you are on your own, the embassy will not be there for you....

after D day...

The next day was also an off day for me….I woke up early and started to read whatever that had left out. It was a relief when I learnt that there was no curfew nor any bleeding event had taken place.

I saw the clip of Dr M in his residence preparing to head for the palace. It had been a harsh night for him, staying up late and managing the taking over. I prayed for him hoping that nothing would happen to him during the process. Everything had gone smoothly, I had witnessed the swearing in later over the net.

During my breakfast with Xian, I had updated what had happened and I could tell from his look that he was actually confused about why I was so excited about…

I lived in a hybrid community; my neighbors were Indian and Malay. The politicians had created an issue regarding difference of races. We were being taught that 3 major races should live in harmony however there was something regarding rights, economy inferiority that was being stressed from time to time. I belong to the group which has economical advantage; but in fact, my family was not doing well then; thence I was not eligible to any government aid….

I hate those racist remarks made by those political opportunists. As the opposition grew stronger since the last two GE, racist remarks were more harsh than ever and I feared that one of those days, we might be marginalized and eventually lost everything. After years of living abroad, I had never forgotten the land where my blood spilled and never have a single thought of giving up my nationality.

Will there be any changes, I doubt it, however deeply in my heart , I knew if the PH had lost, we would be in deep sxxt but fortunately…. 

2 days later, when I met my fellow Malaysian colleague at work, we did not have any deep chat regarding the changes but yet an exchange of smile was something good enough to celebrate the victory.....

D day.....

Finall, the day had come… it was off day for me and I woke up early as usual. I tuned into Astroawani website and started to view the morning live show.

It was an exciting day for me, after weeks of googling and gathering information. I concluded that there was still a slim chance. The survey from Merdaka center was an interesting one which shown a further down sloping of BN vote to 37.3% in the Peninsular but still won the election.

I sent both the kid to school settled back to the screen after breakfast with Ving. Everything was calm but the voting rate was alarming. In the past, the opposition won more if the voting rate was high. However the voting rate was still low at 2pm. I called up my dad and my bro-in law. They have told me the same story, the voting process was very slow. They had waited a long time to cast their vote. The process of staining finger was time consuming and they had waited a long time to finish the casting.

I took a nap and by 6pm after our dinner. I was sitting in front of the monitor;  anxiously switching from webpage to webpage, podcast to podcast trying to get the latest update of the final result.

The BN had the lead but the seat came mostly from the east side. By 9+pm, the opposition had retained Selangor and Penang. However the Parliament result was still sluggish, the possibility of change was higher as the clock tick. Everything went stagnant by 11pm. No new update was noted for the Parliament; BN had taken a lead which was mostly contributed from the east. Perak, NS, Malacca had fallen to the opposition I was pretty sure that a change would be happening but yet I was very worried about a curfew or other tactics being use to prevent the transition.

At 1am, no update was noted and opposition had accused that the SPR was responsible withholding the result. Even the palace had issued a statement requesting the SPR to speed up the announcement. At that time BN had only retained Pahang. Kedah and Sabah were at stalemate. The Hope Alliance had won the election apparently. BN had cancelled its press conference and indirectly admitting their defeat. I took my last sip of red wine from my glass and gone to sleep at 1:30am, praying that no hanky panky staff will interfere with the transition……

D-day...D-1....

Day by day passed and I was hoping get my ballot paper on time. As the day draw closer, my anxiety rises; my option had changed from EMS to courier services that offer same day or next day services. I had read through the net and found that there is fellow Malaysian who was willing to deliver the ballot paper to relevant office…. My options had run out as the countdown tick; mailing option had faded out and my final option was to fly back and delivered it personally. If I could receive my ballot paper on 5/7, I would take a flight back on 5/8 and delivered it to the office on 5/9 as the flight from TPE or KHH arrived in KUL late in the afternoon. So receiving the paper after 5/7 was hopeless…..

Well, at the 5/7 evening, I had given up hope and thought that the ballot papers should have been swallowed by someone. At the noon of 5/8, a courier van came and I got 2 DHL envelopes…. The date of posting was 5/5….4 days before the ballot day, apparently the SPR does not want us to vote. I grinned and told Ving about the news. I was not worried as my voting area was stronghold of PH…but yet, I despised the act of SPR of playing dirty.

Nomination day = 4/28, local postal voting date = 5/4, to be fair, we should have received my ballot paper before 5/4. However the ballot papers were sent out on 5/5, 1 days after the local postal voting. There was only a 4 days window for the ballot paper to reach the respective voter. Unless the courier service could be done on a next day arrival basis it was a mission impossible, furthermore, 5/4 was Friday, the delay over Weekend would be obviously another obstacle….

Well, nothing could be done…

Over those few days, the ruling party had stressed over the media that there would not be any tsunami. However the Merdeka Survey Center had published a very queer survey stating that the BN vote would be down to 30+% but would still retained control over the parliament. Weird indeed, but I felt that the result was actually being manipulate before it was published.

post ops....

Ving left us by 2pm and I took over the job of nursing aid. Xian woke up and he was troubled by wound pain. Xian sensory perception was outstanding he had good eye sight, good hearing and also very sensitive to pain. He had no problem of tolerating the pain while laying still, but the pain was torturing when he attempted to get down from bed.

Urine output was an important index for post ops care…5 hours past the surgery and Xian had tried very hard and no urine output was noted. He felt uneasy to do it on the bed and we had tried a lot of method; sitting over the bedside, sitting on the toilet. Every single way led involved getting out from bed and both of us were exhausted. After 9 hrs of struggle, he had finally emptied his bladder. He was indeed dehydrated, over 2000cc was infused/drunk and only 300cc of urine noted. I felt comfortable but did not enjoy a good night sleep. I had awakened on hourly basis to check on the drip and Xian condition.

The pain was better on D2 but was still disturbing. Ving visited us on twice a day bringing us food and supply. On D3, the bed next to us was discharged and I had chartered the room. Nowadays, single occupancy room in the hospital had become very difficult to get as many patients had insurance and afforded to stay in a single occupancy room. When the single room is not available one could still chartered a double room and turn it into a single room (the pay was of course more expensive). When Xian got admitted there was no single room nor any double room to charter. I had to squeeze myself on the foldable chair for first 2 nights.

Taking care of patient with post abdominal surgery was not a simple task. The mission of going to toilet is a great challenge. Every steps was pain and it took forever to complete the few meter walk.

I had day shift on D3 and Ving had come to look after Xian but he was way better and the pain was much tolerable…

Xian was discharged on D5 but it was not the end of the story…..

the destiny road....D1

Xian was complaining of abdomen distension and easy satiety since early this year. I had given him some antacid but did not seem to work….I was a little bit worried but did not come out with any definite diagnosis until that day…..

I was finishing my night shift and Ving had called me up and told me that Xian is having fever and abdominal pain. I asked about diarrhea and vomiting and Ving had given me a negative answer. I asked Ving to pass the phone to Xian and asked him to do a deep palpitation over his rt and left lower abdomen. Xian knew how to do it as months ago, he had an episode of abd pain with fever and I did a physical examination over him. He given me an answer that I did not want to hear…..

I told Ving to grab some clothing and send him over to the hospital after dropping Yun at school.

I was praying while waiting for their arrival, hoping for a non-surgery miracle but I knew that the great one had made his decision. Xian had arrived in a bitter melon face; he had kept asking me what would happen to him….I told him we would proceed with the CT scan and see that how would the event progress….

Xian had told me during the process that the pain had started around 3am and he was hoping it become better in the morning after he gone to toilet. The pain was initially over the epigastric region….Well, typical appendicitis story, but CT is currently the key to definite diagnosis.

I pulled some string for an urgent CT and informed my general surgeon colleague about a possible case of appendicitis.

The CT had confirmed the great one decision and I broke the news to Ving. Xian was still in his denial stage and kept telling me that he would be doomed. The next decision was to do a laparoscopic or traditional appendectomy. The decision was actually simple as Xian appendix was retrocecal and very long; its end almost in contact with the liver tip. I told my colleague that I would opt for a traditional appendectomy. Again, I told my anesthetist that I would like to join the team for the anesthesia period as Xian would be very anxiety facing the ops. After a short wait, Xian was send to the theatre and I entered to aid the process. The anesthetist and his team were friendly enough to joke around and tried to pacify Xian anxiety. Xian had fallen into sleep after diprivan was given….I left the room and joined Ving at the waiting room for an agony  wait. 45 mins after the ops start, the OT nurse who came out and picked up their lunch box had told me that they were closing the wound and asked me to the joined team . I finally sighed and feeling of fatigue had swarmed over my body; no rest was noted after last night stressful shift….

I entered the OT and saw the culprit; the appendix was swollen and it was the biggest one I had seen for decade. Extubation was done and I had chat with the anesthetist while waiting for Xian recovery from anesthesia. He told me the traditional method was a good choice; once there was a gynecologist who opted for laparoscopic appendectomy and ended up with a rupture of appendix while being removed from the peritoneal cavity. The consequence was a one month open dressing of wound.

Well, everything was smooth until now, but I knew that the worst was waiting for me….

D-day.....prelude

My feeling toward GE14 was complicated, after all those of years of frustration, I had given up hope that any miracle would happen…….Earlier this year, I was looking forward to the date of GE14, it would mean another trip up north for all of us. However I was wrong, the SPR had announced that the postal vote with be sent by post and we would have to sent it back to the returning officer before 5pm on the date of election. For a moment, something inside of me had urged me to fly back and carried out my duty, but it was not feasible as kiddo will be schooling and Xian is about to face his form 3 examination; it would be a unfair to the rest of the family if I fly back alone. So it was postal voting again for both of us. The registration was actually a painful one. Flipping through my passport was not enough to fill in the section of stay in Malaysia; the autogate entry[both in Malaysia and Taiwan] had left no stamping on the my passport. My reliable source was the airline company records. I took me quite sometimes to complete the registration.

I got the confirmation email about my application few days later. News regarding GE were starting to flood the media; all I saw was those old tricks…threatening about losing right, racist remark. Those all tricks had been working since my childhood, It had worked many times and I can’t find any reason that it shouldn’t this time, but there was this small flame in my heart that hoping for a change….

life of a developer....

It had been a year since I had dipped into the world of web developer...The progression was slow as I was stuck with the aspx way of retrieving data from database. I had written a wcf service but was unable to proceed as my NAS had an ARM processor and I was unable to host aspx....
I had read up a lot but was unable to make a good leap. I decided to use the html ajax php method. The project is to build a mobile EMR so that I can use mobile phone, tablet during my future medical mission. Well, it is more difficult than aspx and wcf but yet worth a try.
There were lots of resource over the net but the learning process was slow as I need to get answer from time to time by googling. The project was changed after a short while to a CPR recording mobile webpage. I got the inspiration from a local beef shop POS system which utilized mobile phone for counting how many plates the customer had consumed. A simple listview with a long list of button; just click the relevant items and sent...
I managed to get the listview working in 1 months and I was stuck with the datajson to php part.....There were a few technical details which is not mentioned over the net. It took me few weeks and I had completed module of ajax , json, php to and fro mysql server, the job was completed but there was another task waiting for me...

Since 1+ years ago, Ving was given the task of doing roll call in the church. The task is a complicated one as it involved counting the head not only during the mass, but also others activity. Name lists came from 4 different section in small piece of papers and she would need to enter the name onto the national roll call list over the net. If would often need 2-3 hours to complete the task. I had occasionally help her out and found that it could be done a more effective way….

The project started small with only one webpage and a database to manage…It later bloated up like a balloon….I gained many skills, techniques by googling…The task seems simple initially; chose date->chose gathering type->tick who was present from the listview-   >save[write to database]. 

However later I decided it should be reproducible; you can click the date and the data is retrieved so that you don’t have to tick the whole list again should you wanted to add or delete entry…

Then someone asked for a weekly statistic list…another one asked if visitor could be added…again someone asked  if visitor could be placed on the list for a certain period…so and so and so customization were requested…

Well…it took an enormous effort and time for me to coup with those requests… Now it served the whole church instead of our section…..

My next urgent task is to move it out from my NAS ...

let the nature do its job.....

The last few months was an agony not only for me but for my colleague. Our new head of department L had started to 'harass' the ED staff....

Nursing colleagues had been yelled and tagged with unpleasant word equivalent to 'no brainer'. Setting up rules and breaking them whenever he thought was suitable. Nursing staff had tolerated and eventually made complaint but yet the management had asked them to tolerate as L is currently the new kid on the block and the management wishes to rely on him for further advancement.

He had trolled the grey area and sometimes performing unethical acts which violated protocol. Events were reported but no action was taken.....

Nursing staffs are planning for a mass resignation in the near future and I am not happy looking at their plan....

It had been a comfortable working environment until the recent 6 months where L started to 'exercise' his power as HOD. K is one of the victim as L had been stalking him closely. 

I had been irritated but chosen to maintain a 'do nothing' posture....

backlogging....and conclusion of 2017

Appreciation was what I learnt during my last trip. Life was getting harder as the working environment became more hazardous. Interference was noted after Lem left. As the senior staff in our department, I was harassed less. A couple near misses that merely dragged me to medico-legal suit due to some reckless and unethical acts. I had tolerated such events and decided to do nothing…

A trip back to Malaysia was planned and it was a complicated one for me. I had not been having reunion dinner for over 10+ years with my parents and my brother. As our working force expended, this is the 1^st time in 10 years, I could be able to stay over Chinese new year eve.

The fly thru option was available for K city to Senai airport; it was my first choice but I had something to settle before I made the reservation – the overnight stay in sama-sama KLIA2. Unfortunately, it was not available at the time I did the search. Well, I had to give up the idea of getting fly thru but to do 3 separate purchases. KHH->Senai(fly thru), Senai->KUL, KUL->KHH. The interesting part was the price was NT10k less than purchasing a to-fro fly thru. I had noticed it sometimes ago and found that, the price of round trip from KUL to KHH vs KHH to KUL is different. You get a cheaper price if the initial departure city is KUL.

Well, I secured a room with the Plaza Premium lounge at KLIA2 gateway at the price of 1/3 of sama-sama (breakfast also included !!!).     

Despite of being disturbed on my job, I was struggling to learn JAVA; a tough task for a person with 70% of white hair….